UIC COLLEGE OF DENTISTRY
ASSESSMENT OF CARIES RISK FACTOR

Patient::____________________________________ Date:_____

                                                    Check the appropriate cell below
Factors: Positive affect Negative affect
A. BACTERIAL ASSESSMENT (may be useful with cavitated lesions)
     MS test results: 

     Lactobacilli test results
:                

<100,000

<10,000

>100,000

>10,000

B.  DIET
     
-Snacking and sugar intake habits.

      -Food excess and deficiency
                       

C. HOST RISK FACTORS
     1. Medical History:
        -Medication with sugar base.
        -Medication inducing Xerostomia.
        -Mental or physical impairments.

     2. Dental History:
         -Last dental visit
         -Brushing habits
         -Oral rinses other than fluorides.
         -Past dental history

     3. Fluoride Use:
         -Past and current use.
         -Water intake

     4. Salivary Flow Rate: (ml/ minute)

     5. Clinical Examination:
-Plaque Index
-Carious lesion evaluation (to be used along with standard caries chart)

FINAL RISK ASSESSMENT

Based on the history and evaluations determine risk classification of patient, if patient is caries active or inactive.
Low Risk 

Moderate Risk  

High Risk

Caries inactive

 

 

 

Caries active
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